冠心病颈动脉超声参数AC、β及IMT与冠状动脉病变的关系

Relationship between carotid ultrasound parameters AC,β and IMT and coronary artery lesions in coronary heart disease

目的分析冠心病颈动脉超声参数颈动脉顺应性(AC)、颈总动脉硬化度(β)及颈总动脉内⁃中膜厚度(IMT)与冠状动脉病变的关系。方法收集2019年10月至2021年10月联勤保障部队第九八八医院收治的115例冠心病患者临床资料(冠心病组),根据病支数不同分组:1支冠脉病变(冠脉狭窄>50%)35例,2~3支冠脉病变80例;根据Gensini评分为轻度(Gensini评分<20分)39例,中⁃重度(Gensini评分≥20分)76例。另选取本院同期健康体检者98例作为对照组。对比不同人群、不同冠脉病变支数患者以及不同Gensini评分患者中颈动脉超声参数AC、β及IMT;分析颈动脉超声参数AC、β及IMT与冠状动脉病变的关系。结果冠心病组颈动脉超声参数AC、β及IMT均明显高于对照组,差异有统计学意义(P<0.05)。2~3支冠脉病变颈动脉超声参数AC、β及IMT均明显高于1支冠脉病变,差异有统计学意义(P<0.05)。轻度组患者颈动脉超声参数AC、β及IMT均明显低于中⁃重度组,差异有统计学意义(P<0.05)。动脉超声参数AC、β及IMT与患者冠脉病变支数为正相关(r_(AC)=0.613,r_(β)=0.488,r_(IMT)=0.519,P均<0.001),与患者Gensini评分为正相关(r_(AC)=0.633,r_(β)=0.519,r_(IMT)=0.506,P均<0.001)。结论冠心病颈动脉超声参数AC、β及IMT与冠状动脉病变之间密切相关,颈动脉超声在冠心病早期筛查中有较好的应用前景。

Objective To analyze the relationship between carotid ultrasound parameters carotid artery compliance(AC),common carotid artery stiffness(β)and common carotid artery intima⁃media thickness(IMT)and coronary artery disease in patients with coronary heart disease.Methods The clinical data of 115 patients with coronary heart disease admitted to the 988th Hospital of the Joint Logistics Support Force from October 2019 to October 2021 were collected(Coronary heart disease group),and grouped according to the number of diseased branches:1 coronary artery disease(coronary artery stenosis>50%)35 cases,80 cases of 2⁃3 coronary artery disease;according to Gensini score,39 cases were mild(Gensini score<20 points),and 76 cases were moderate⁃severe(Gensini score≥20 points).In addition,98 healthy subjects in our hospital during the same period were selected as the control group.The carotid ultrasound parameters AC,βand IMT in different populations,patients with different coronary artery disease branch numbers,and different Gensini scores were compared;the relationship between carotid ultrasound parameters AC,βand IMT and coronary artery lesions was analyzed.Results The carotid ultrasound parameters AC,βand IMT in the coronary heart disease group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The carotid ultrasound parameters AC,βand IMT of 2⁃3 coronary artery disease were significantly higher than those of 1 coronary artery disease,and the difference was statistically significant(P<0.05).The carotid ultrasound parameters AC,βand IMT in the mild group were significantly higher than those in the moderate⁃severe group,and the difference was statistically significant(P<0.05).Arterial ultrasound parameters AC,βand IMT were positively correlated with the number of coronary artery lesions(r_(AC)=0.613,r_(β)=0.488,r_(IMT)=0.519,P<0.001),and were positively correlated with the patient's Gensini score(r_(AC)=0.633,r_(β)=0.519,r_(IMT)=0.506,P<0.001).Conclusion The carotid ultrasound parameters AC,βand IMT of coronary heart disease are closely related to coronary lesions,and carotid ultrasound has a good application prospect in the early screening of coronary heart disease.